炎症性腸疾患と幼児期における家庭衛生

A E Gent¹, M D Hellier, R H Grace

¹Salisbury District Hospital, Odstock, Wiltshire, UK.

Lancet (London, England)

|March 26, 1994

まとめ

クローン病は,人生の初期に現代的な衛生状態に曝されたことと関連している可能性があります. この研究では,クローン病と幼児期に温水蛇口と別々のトイレを持つとの相関が判明しました.

科学分野:

胃腸内科胃腸内科
エピデミオロジーエピデミオロジー
環境衛生環境衛生環境衛生

背景:

クローン病の発生率は,過去50年間で先進国において著しく増加しています.
クローン病の正確な原因は不明であり,遺伝的傾向や環境要因を含む仮説がある.
腸内感染症への遅延暴露は,クローン病の潜在的なトリガーとして提案されています.

研究の目的:

幼児期の家庭の設備とクローン病の発生との関連を調査する.
クローン病の環境リスク要因と潰瘍性大腸炎の環境リスク要因を区別する.
現代の衛生状態がクローン病の病因学に影響を与えるという仮説を検証する.

主な方法:

ケース・コントロール・スタディ・デザインが採用されました.
クローン病と診断された133人の患者と,潰瘍性大腸炎と診断された231人の患者を比較した.
対照群は一般集団から選択され,年齢と性別を合わせた.

主要な成果:

クローン病の患者は,最初の自宅で温水蛇口を持っていた可能性が著しく高かった (オッズ比5.0,95%CI 1.4-17.3).
クローン病の被験者はまた,最初の住居で別々の浴室を持つ頻度が高いことを示した (オッズ比3.3,1.3-8.3).
潰瘍性大腸炎と幼児期の家庭の設備との明確な関連は見つかりませんでした.

結論:

温水蛇口と別々の浴室の存在によって示される現代的な衛生状態への早期の曝露は,クローン病の危険因子である可能性があります.
これらの発見は,過去50年にわたる衛生と衛生上の慣行の変化が,クローン病の発生率増加に寄与する可能性があることを示唆しています.
衛生状態とクローン病の病原性を結びつけるメカニズムを解明するために,さらなる研究が必要である.

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